5613475 ADVERSE REACTIONS TO RBC TRANSFUSION: A SINGLE THALASSEMIA AND SICKLE CELL DISEASE DEPARTMENT’S EXPERIENCE
Authors: A.X. Xydaki, A.K. Kotsiafti, K.M. Manganas, A.P. Paraskeva, E.P. Pavlou Efthimia, K.P. Politis Konstantina, S.D. Delicou
Journal: HemaSphere (2023)

Background: Thalassemia and Sickle Cell Disease patients require regular blood transfusions and iron chelation treatment for the entirety of their lives. Several patients had transfusion-related side effects as a result of frequent and chronic transfusions. Methods: In this study, we analysed the frequency of transfusion reactions and the methods used to address them by reviewing the medical records of 95 patients who received multiple transfusions on a regular basis during a 20-year period. All demographics and charactiristics are in TABLE 1. Table 1: - The Demographics and Characteristics Compared TYPE OF HEMOGLOBINOPATHY β-Thalassemia (51.3%) α-Thalassemia (2.6%) Sickle Cell Disease (12.8%) β-thal/SCD (15.4%) AGE AT THE ONSET OF TRANSFUSIONS < 2 years old (45.7%) > 20 years old (11.4%) > 30 years old (34.3%) occasionally (8.6%) TRANSFUSION FREQUENCY weekly (2.7%) every 15-20 days (54.1%) monthly (34.3%) exchange transfusions (2.7%) Results: Over a 20-year period, 42 percent (42,1%) of the 95 patients who received repeated transfusions reported at least one adverse event during the transfusion (about two per year reported). Our unit’s usual clinical practice is to transfuse patients with Leukoreduced RBC to prevent HLA alloimmunization, CMV transmission, and fever nonhemolytic transfusion reactions.Fever (48.1%), chills (18.5%), anaphylaxis/urticaria (11.2%), swelling (3.7%), hemolysis (11.2%), yersinia enterocolitica (3.7%), and alloimmunization (3.7%) were the most common side effects reported by patients experiencing a transfusion reaction (image 1).In each case, the transfusion was discontinued and the reaction was treated according to local clinical practice. Antibiotic therapy was used to manage infectious complications. Extended blood type matching (ABO, CcDEe, Kell, Duffy, Kidd, MNS,Lewis, Lutheran, etc) has been used in clinical practice as a prophylactic intervention in the case of hemolysis or alloimmunization. Before receiving washed red blood cells in future transfusions, some patients with fever or allergic responses were administered premedication with antihistamines or antipyretics. Nine patients (22.5%) of patients those who had experienced a previously adverse reaction reported a second episode with the following symptoms: allergic reaction/urticaria (44.5%), fever (33.5%), and alloimmunization (22.5%). Patients who developed alloimmunization during the second adverse transfusion event had no history of alloimmunization previously. Conclusions: In the studied population, there was no high prevalence of serious or fatal transfusion adverse effects. Every transfusion requires constant vigilance for the occurrence of transfusion reactions, especially in patients who have received multiple transfusions. References 1. Lal, Ashutosh. “Challenges in chronic transfusion for patients with thalassemia.” Hematology 2014, the American Society of Hematology Education Program Book 2020.1 (2020): 160-166. 2. Propper, Richard D. “Current concepts in the overall management of thalassemia.” Annals of the New York Academy of Sciences 344.1 (1980): 375-383.